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Operative Hip Arthroscopy - part 9

wo đoàn hệ với những tác động rất phổ biến phát triển của chứng loạn sản và người già. Một xu hướng chung cho hip Cả hai bệnh lý tồn tại trong quần thể, và Cả hai đều được coi là chung để trở thành người báo hiệu kết quả nghèo với nội soi khớp. Tuy nhiên, nội soi khớp vai trò trong | 5 Unique Populations Dysplasia and the Elderly J.W. Thomas Byrd Two cohorts with common implications are developmental dysplasia and the elderly. A propensity for hip joint pathology exists in both populations and both are generally considered to be a harbinger of poor results with arthroscopy. However arthroscopy has a role in both of these groups and has been instrumental in gaining an appreciation for the pathomechanics associated with various lesions. Operative arthroscopy can meet with significant success when understanding the appropriate indications within these circumstances. DEVELOPMENTAL DYSPLASIA Developmental dysplasia of the hip DDH is not a cause of hip pain. It is simply a morphologic condition that makes the hip vulnerable to an intraarticular lesion that may then become symptomatic. The three most likely structures to be involved are the acetabular labrum articular surface and ligamentum teres. Accompanying a shallow bony acetabulum the labrum may be enlarged assuming a more important role as a weight-bearing surface as well as added responsibility for joint stability. This hypertrophic labrum is thus exposed to greater joint reaction forces and may be at increased risk for developing symptomatic tearing.1-3 Inversion of the acetabular labrum is also known to occur in association with dysplasia being entrapped within the joint and again being a source of painful tearing.4 5 The reduced area of the acetabular articular surface results in increased contact forces 6 7 which can result in early development of degenerative wear and may make the articular cartilage more vulnerable to acute fragmentation.8-11 Third elongation or hypertrophy of the ligamen-tum teres accompanies lateral subluxation of the femoral head within the acetabulum.12 13 Entrapment of this ligament can be a source of significant me chanical hip pain whether from its redundant nature or partial degenerate rupture. Thus dysplasia is well recognized as an etiologic factor in the .